This is a three year demonstration project testing the relative effectiveness of centralized and decentralized service delivery organization in maintaining older persons in the community. The research design involves two teams and two control groups who will be compared over a twenty-four month period on several classes of variables: The independent variables are (1) Team versus Service Demand and (2) Geographical Location (northeast versus northwest). The dependent variables are : Service Delivery Pattern (speed, frequency, appropriateness), Number of Clients Served, Accessibility of Services, Client Level of Functioning, Client Satisfaction, Differential Staff Use, Staff Satisfaction, Unit Cost for Services, Community Living or Institutionalization. The effectiveness of the two approaches in meeting the following five goals is being evaluated: (1) Maintaining older persons in the community; (2) Reducing the cost of services by using staff differentially; (3) Optimizing accessibility of services; (4) Improving continuity and comprehensiveness of services; (5) Enhancing staff morale. The two service delivery systems are compared through an empirical investigation which relies on a statistical analysis to determine the differences between the two service delivery systems in meeting the five above stated goals. A Cohort Analysis will be conducted whereby the treatment careers of clients under either team or demand systems are being compared over a 24-month period on a wide variety of "accountability measures."